Fear Factor: You CAN overcome phobias

Don’t Be Afraid!

Photo: GettyImages/Peter Dazeley

By Lee Nelson/HealthyLife

Do you shriek when you see a spider? Do you get clammy hands and palpitations when you go to the dentist? Everyone has fears — crowded elevators, tall ladders, mice, public speaking; the list goes on and on.

You probably can avoid going to tall buildings if you’re afraid of heights. You can keep your cool if you see a bee, even though they scare you to death. Most people can deal with that fear internally or avoid places and things so they don’t have to face it. Their lives go on.

But, for some, it’s not that simple. Their lives are affected drastically when that fear becomes a phobia. Their involuntary and irrational reaction to a thing, situation or idea can devastate their lifestyle and relationships or give them panic attacks.

“Most of us carry a certain degree of anxiety. But it’s when those fears become extraordinary and interfere in enjoying life that something has to be done,” says Alan Barnett, clinical psychologist in Clifton Park. “I thought I was fearful of heights until I went to the top of a ski jump at Lake Placid. I went out to the end of the platform. I realized then that I wasn’t afraid of heights. I was afraid of falling.”

He’s since visited many high places including the Empire State Building. “It’s high up there but it is enclosed. I can go to places that are tall as long as they have railings or enclosures. I am OK. I just won’t be jumping out of airplanes anytime soon,” he says.

But for his patients who come to him with fears that interfere with their lives, he works with them to gain a set of skills to address those phobias and desensitize them.

Phobias are anxiety disorders and can be caused by an assortment of things, including genetics, brain chemistry, environment, traumas and other biological and psychological influences, according to the website of the Anxiety Disorders Association of America.

The association denotes three groups of phobias. The first and most common are specific phobias with fears of specific objects, animals, places and situations. The second is social phobia or social anxiety disorder, which causes extreme anxiety when in a social or public setting. The third is agoraphobia, the fear of being surrounded by large numbers of people or having a panic attack in public places where you can’t easily escape.

Phobias can ruin lives, families and dreams. But there is help out there.

Specific phobias afflict 19 million adult Americans, with twice as many women as men affected, says the National Institute of Mental Health website. Often, the phobia is accompanied by depression or substance abuse. Phobias can ruin lives, families and dreams. But there is help out there.

“Anxiety is a natural part of our experience. For someone who helps those with phobias, my goal is not to rid my clients of anxiety but to help them cope with it,” says Melissa Them, clinical psychologist at Health Psychology Associates in Albany.

She is working now with a woman with social phobia, who desperately wants more friends. But the woman worries that people will judge what she’s saying or that she’s not smart enough.

“Her co-workers ask her out, but she comes up with some excuse every time,” Them says. “She’s very lonely. She’s not living a full life, but she wants to.”

Them is helping her understand that the negative thoughts the woman imagines others have about her are actually just coming from her own mind. “Once you lay a foundation of cognitive restructuring, then the behavior component can come in,” she says. “I can teach her skills to keep her body under control so she doesn’t go into a panic attack.”

Through the years, Barnett has had patients afraid of thunderstorms, snakes, flying and more. But usually the fears run in clusters, such as fears of animals or fears of physical injury with natural events such as hurricanes or thunderstorms.

“If you use avoidance, you never overcome the fear,” he says. “Avoidance convinces yourself you were right all along. We want them to come to terms with that fear or confront it in protective steps.”

The fear of flying is quite common and can be a devastating phobia for those who have jobs that require travel or those with family spread out across the country. Martin Seif, founder of the ADAA and clinical psychologist in New York and Connecticut, suffered from his own fear of flying years ago.

“Getting over my fear of flying was one of the most difficult achievements of my life,” he says.

Fear of flying is not just a single phobia. Those afflicted also may be claustrophobic, the fear of having no escape or being in cramped quarters, or other anxieties such as fear of heights, he says.

Thirteen years ago, he created the Freedom to Fly program at the Anxiety and Phobia Treatment Center at White Plains (N.Y.) Hospital, where he serves as associate director. He also is founder of the ADAA.

The program is a six-session program with the participants actually flying at the last meeting. He understands why people fear flying: it seems unreal that a big, heavy plane can get off the ground and stay in the air. People know that flying is a safe way of traveling, but statistics don’t stop their fears. Nearly 20 percent say the fear interferes in their work or social lives, Seif says.

“There are rare cases where they decide not to fly on that sixth session. But we give them a lot of information and teach them to look at their anxiety differently,” he says. “They learn to control the fear instead of fighting it.”

Coming face to face with the fear has proven through the years to help many people come to grips with their phobias. “The name of the game is exposure. People have to come into contact gradually with the thing they are afraid of,” says David Tolin, clinical psychologist and author of the 2012 book, Face Your Fears: A Proven Plan to Beat Anxiety, Panic, Phobias and Obsessions. He also is a featured expert on the A&E cable television series Hoarders and director of Anxiety Disorders Center Institute of Living at Hartford Hospital. “We retrain the brain not to have an alarm reaction and to keep pushing what the person can do and face,” he says.

For example, one of his clients had been afraid of snakes since she was a little girl. She now was in her 50s and still struggling. She was getting to the point of avoiding going outside or letting her grandkids go outside to play when she watched them.

“She knew it was silly, but she was still fearful. The impact on her relationships was growing,” he says. “We started her out with looking at pictures of snakes, then bringing in a snake into the same room with her, and then having her touch the snake.”

By the time her sessions with Tolin were through, she was able to have a snake crawl across her arms without having panic attacks or any other exasperating feelings. “They weren’t doing anything bad to her so her fear subsided,” he says. “She found she was no longer impaired. She can go anywhere now and walk across grass or take a hike in the woods.”

At his center and with many anxiety centers, virtual reality programs can be used to give someone the feeling, for instance, of being at the top of a tall building, or giving a speech to a large group of people. “You can simulate something and let them practice over and over again like speaking in front of a group that wouldn’t be practical in real life,” he says. “But there is no substitute for reality and facing the fear.” He admits there are a lot of good and bad therapies out there to help those with phobias. “You just have to find which treatment has the strongest scientific evidence. If your fear is unrealistic and way out of proportion, you have to recalibrate the brain,” he says. “But people really can get past their fears.”